Two Questions regarding Medicare....

[RunnerDude]

I have a client who is new to Medicare (turned 65 2/2023). He will continue to work until July or 2023. Even though he still has credible insurance through his work, he has already signed up for part B (started 2/1/2023). His wife is two years older, and only has part A since she is covered under her husband's insurance. The first question is:
1. My client states that he wants to wait until he stops working in June before signing up for a Medicare Advantage plan. If he does this, he will be out of his Initial Enrollment Period. Will he have to use form CMS L564 to provide he had credible coverage at that point? I'm thinking he just needs to sign up for an MAPD plan before the end of May 2023.

The second question has to do with his high income due to receiving an inheritance last year. He is currently paying $230.80 per month based on last year's income. However, since he will stop working in June 2023, his income will drop significantly, and his required payment going forward will be $164.90 per month. Question 2 is...
2. Is there a form he has to fill out for have his part B premium reduced? I read somewhere that the part B premium is based on the previous two years.

Thanks for your help-

 

[Tscholar]

I have a client who is new to Medicare (turned 65 2/2023). He will continue to work until July or 2023. Even though he still has credible insurance through his work, he has already signed up for part B (started 2/1/2023). His wife is two years older, and only has part A since she is covered under her husband's insurance. The first question is:
1. My client states that he wants to wait until he stops working in June before signing up for a Medicare Advantage plan. If he does this, he will be out of his Initial Enrollment Period. Will he have to use form CMS L564 to provide he had credible coverage at that point? I'm thinking he just needs to sign up for an MAPD plan before the end of May 2023.

The second question has to do with his high income due to receiving an inheritance last year. He is currently paying $230.80 per month based on last year's income. However, since he will stop working in June 2023, his income will drop significantly, and his required payment going forward will be $164.90 per month. Question 2 is...
2. Is there a form he has to fill out for have his part B premium reduced? I read somewhere that the part B premium is based on the previous two years.

Thanks for your help-

Yes, he can wait until he retires to enroll in a MA plan. He will just need to use the Employer Group SEP: He will have 2 full months after the month his coverage ends to sign up for a MA plan. You're correct, part B premium is determined from two years back, so, in this case, the 2021 tax year. If he is paying more than the standard amount, he can call SSA to appeal IRMAA, if his new income qualifies.

 

[RunnerDude]

Thanks for the info. Also, if they choose to enroll in a MediGap plan, when does the guaranteed issue period start and end?

 

[Chazm]

Thanks for the info. Also, if they choose to enroll in a MediGap plan, when does the guaranteed issue period start and end?

It’s based on Part B effective date or 65 birth month. Ends after 6 months of either.

 

[Fisher]

It’s based on Part B effective date or 65 birth month. Ends after 6 months of either.

I think you've got that worded incorrectly, Chaz. A person could be 80 when they finally enroll in Part B and would be in Open Enrollment for 6 months.

 

[pogo]

His wife needs to sign up for Part B, too, effective in July. She can also use the SEP for Lost Employer Coverage.

As for IRMAA, he could talk with someone at a local SS office to explain the circumstances as an alternative to filling out the standard form to request a redetermination.

To enroll in a Medigap, he has 6 months after his Part B is effective. With his effective date of 2/1, that would mean he needs to enroll by the end of July. If the wife enrolls in Part B effective July 1, she needs to enroll by end of December. Of course, for both of them, enrolling in a PDP has to be done within the 63 days allowed by the SEP LEC.

 

[LostDollar]

Also, if they choose to enroll in a MediGap plan, when does the guaranteed issue period start and end?

https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap

 

[LostDollar]

2. Is there a form he has to fill out for have his part B premium reduced? I read somewhere that the part B premium is based on the previous two years.

https://www.medicareinteractive.org...aling-a-higher-part-b-or-part-d-premium-irmaa

This is a link inside that article:

[EXTERNAL LINK] - Request to lower an Income-Related Monthly Adjustment Amount (IRMAA) | SSA

 

[LostDollar]

I have a client who is new to Medicare (turned 65 2/2023). He will continue to work until July or 2023. Even though he still has credible insurance through his work, he has already signed up for part B (started 2/1/2023). His wife is two years older, and only has part A since she is covered under her husband's insurance. The first question is:
1. My client states that he wants to wait until he stops working in June before signing up for a Medicare Advantage plan. If he does this, he will be out of his Initial Enrollment Period. Will he have to use form CMS L564 to provide he had credible coverage at that point?

L564 relates to Part B application which has already been done.

 

[Chazm]

I think you've got that worded incorrectly, Chaz. A person could be 80 when they finally enroll in Part B and would be in Open Enrollment for 6 months.

I said OR though. The application ask did you enroll in Medicare or turn 65.

edit: I see. You meant my second part. Yeah, I don’t mean it ends after either happening.